In a conventional prescription claim billing process, a payor/processor may return a particular claim to a pharmacy as a reject. Rejects may be anomalies or there may be a global issue that causes an abnormally high occurrence of rejects. The global issue may be with the payor/processor or with the pharmacy. These types of issues typically require manual intervention for resolution, which can be time consuming and expensive. For instance, if conventional processes are followed, it may take an inordinate amount of time and a relatively high number of similar rejects to notify each relevant party of the associated issue or reason for the reject. In some instances, identification of an issue or reason for the reject may be based on anecdotal evidence which may not be timely or an accurate indicator of the issue or reason for the reject. This may result in the reject of many other or subsequent prescriptions claims and customers may not be accommodated in a timely manner.
Therefore, a need exists for systems and methods for real-time monitoring and analysis of prescription claim rejections.
In addition, a need exists for systems and methods for a transaction performance monitoring system for facilitating the real-time monitoring of the rejection of prescription claims.
Therefore, a need exists for systems and methods for a transaction performance monitoring application for facilitating real-time monitoring and analysis of rejections of prescription claims communicated between at least one dispenser and at least one payor.